General election 2019: What do the party manifestos spell out for pharmacy?


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By Costanza Pearce, Mimi Launder
Reporters

29 Nov 2019

Costanza Pearce analyses what each of the major parties has planned for pharmacy if they win next month’s general election

As we draw ever closer to election day on 12 December, politics and propaganda are dominating the news. Aside from Brexit, promises about the NHS have been at the forefront of the parties’ tactics to curry favour with the general public.

But what do the manifestos actually say about pharmacy and the areas that affect the sector?

Here’s our roundup of everything you need to know, with a handy thematic breakdown to compare each pledge side by side.

 

Conservatives

The only specific mention of pharmacy in the Conservative party manifesto comes in the form of a workforce pledge – that 6,000 more pharmacists, nurses and physiotherapists will be recruited into general practice on top of those already committed for primary care networks (PCNs). However, no specific mention is made of what proportion of this staff windfall will be pharmacists.

As for the funding promised to the wider NHS, doubts have been cast over the Tory claim that it will bring the biggest cash boost in modern memory. Fact-checking charity Full Fact pointed out that in real terms, the £34 billion promised equates to £20.5 billion a year due to inflation – less than spending in 2004/5 and 2009/10. Thinktank the Health Foundation also raised concerns that the funding boost – equating to a 3.3% rise on average per year – is below the 3.4% needed to maintain current standards and ‘far short’ of the 4% needed to deliver the NHS Long Term Plan.

Most notably, the manifesto is adamant – mentioning it not once, but twice – that the NHS, the price it pays for drugs and the services it provides ‘will not be on the table’ in trade deal negotiations. This too seems to be murkier than it might seem, after this week’s row over labour leader Jeremy Corbyn’s claim that he has seen leaked documents showing that the NHS has been included in trade talks with the US and will be at risk under a post-Brexit deal with the Tories at the helm.

 

Labour

The Labour party – the only party to specifically mention community pharmacy in its manifesto – has made two intriguing pledges. Firstly, to ‘ensure community pharmacy is supported’ and secondly, to allocate a ‘greater proportion of overall funding to close-to-home health services’. Your guess is as good as ours as to what those might mean in reality. We have asked for clarification and will be sharing anything further that we learn.

The manifesto’s financial promises – which equate to 4.3% extra funding a year on average for the NHS – were comparatively better received by independent thinktanks and bodies than their Tory counterparts, with The King’s Fund calling them ‘comprehensive’ and the Health Foundation saying they were ‘welcome’. However, the success of a funding boost would be reliant on sufficiently increasing workforce numbers.

The party has also promised to scrap prescription charges in England, put an urgent measles vaccination plan in place and improve access to primary care services for patients in deprived and remote communities.

Finally, it probably goes without saying that Labour too made a point of stating that ‘all parts of the NHS… are fully excluded and protected’ from any international trade deals they might make if they are elected into Government.

 

Liberal Democrats

The Liberal Democrats’ manifesto probably has the most to say about healthcare as a whole, but its only mention of pharmacy is no less vague than its rivals. If elected, the party has promised to make ‘greater appropriate use’ of pharmacists and other healthcare professionals (HCPs) to tackle the GP workforce crisis.

It’s great to see a recognition that ‘urgent workforce shortages’ must be tackled alongside some fairly detailed plans of how to do so. Also interesting is the pledge to encourage HCPs to work in areas with staff shortages with financial incentives, but it remains to be seen whether this will apply to pharmacists.

The funding promised to the NHS – which includes a ringfenced £7bn per year raised through a 1p increase on income tax – was welcomed by the Nuffield Trust but also criticised for leaving some ‘big unanswered questions’. The thinktank said the proposal ‘could mean cuts’ if revenue were to fall, for example during a time of economic downfall.

The flagship pledge of the Lib Dems is to ‘stop Brexit’, so it’s no surprise that making sure we don’t leave the EU forms the baseline for many of the party’s NHS plans. The manifesto says that Brexit ‘would pose serious threats to the sustainability of the NHS’, so preventing it will boost the recruitment and retainment of staff, avoid ‘potential delays to medicines’ and keep NHS services and the UK drugs market safe from US corporations.

 

Green party

Under the Green party, pharmacies would help ‘regulate access’ to recreational drugs by providing them at fixed doses and prices following a ‘safety consultation’ with a pharmacist. Heroin would also be made available on prescription following a medical assessment by a doctor, as part of a policy to ‘treat problematic drug use as a health issue, not a crime’.

Among major plans to reverse privatisation and devolve healthcare into local communities are promises to make sure the workforce is sustainable and to build new community health centres that ‘pioneer preventative healthcare’.

Meanwhile, the party has pledged to increase NHS funding by at least £6 billion per year until 2030, which represents a 4.5% increase on the 2018/2019 NHS budget.

And finally…

 

Vote Pharmacy

Pharmacy bodies have created their own manifesto championing the sector ahead of next month’s election.

The Vote Pharmacy manifesto was developed by the National Pharmacy Association (NPA), the Royal Pharmaceutical Society (RPS) and the Pharmaceutical Services Negotiating Committee (PSNC). It aims to show how community pharmacy offers solutions to many of the NHS’s ongoing problems and to present a united message to parliamentary candidates that community pharmacy has ‘huge potential’ if it is given ‘the right support and investment’ from the Government.

An NPA spokesperson added that the membership body will work with whatever new Government is elected in December to ‘make good on any of the promises made during the campaign’.

 

So, what exactly has each party pledged?

 

Pharmacy

Conservatives – 6,000 more primary care professionals, such as physiotherapists and pharmacists, on top of the 20,000 already announced as part of PCNs

Labour – Will ‘ensure community pharmacy is well-supported’ and provide 27 million more GP appointments per year ‘to support transition to community health care services’

Liberal Democrats – Make ‘greater appropriate use’ of pharmacists, nurses and physiotherapists to help end end the GP shortfall by 2025

Green – Pharmacists to help ‘regulate access’ to stimulant and psychedelic drugs at fixed doses and fixed prices following safety consultation with qualified pharmacist

 

Funding

Conservatives – £34bn per year by the end of Parliament in additional NHS funding – rise of 29% between 2018 and 2023

Labour – Will increase expenditure across the health sector by  average 4.3% per year. Will allocate  ‘greater proportion of overall funding to close-to-home health services’

Liberal Democrats – Raise £7bn per year in additional revenue by putting 1p on income tax – ringfenced for spending on NHS and social care. £10bn of our capital fund to make necessary investments in equipment, hospitals, community, ambulance and mental health services buildings, to bring them into the 21st century

Green – Increase NHS funding by at least £6bn per year until 2030 (a 4.5% increase on the 2018/2019 NHS budget)

 

Workforce

Conservatives – 6,000 more doctors in general practice and 6,000 more primary care professionals, such as physiotherapists and pharmacists (on top of previously announced 7,500 extra nurse associates and 20,000 primary care professionals in PCNs). NHS visa to allow fast-tracked entry and reduced fees to qualified HCPs with an NHS job offer and good working English

Labour – Put safe staffing limits for all staff and agenda for change terms and conditions of service into law. Will invest in, train and develop NHS staff throughout their careers. Will remove obstacles to ethical international recruitment.  Employment of NHS staff ‘fully excluded and protected’ from any international trade deals

Liberal Democrats – Some of the £7bn raised for the NHS to be used to ‘tackle urgent workforce shortages’. Give financial incentives to encourage HCPs to work in areas with workforce shortages, especially inner city and remote rural areas. Use CPD, better support and more flexible working to retain staff. Attract and support HCPs from other  countries (especially EU) – and make the registration process more flexible and accessible without lowering standards. Produce a national workforce strategy ‘matching training places to future needs’. Stop Brexit to improve recruitment and retainment of EU healthcare staff

Green – Make it the health secretary’s duty to ensure there are enough health and care staff to meet the population’s needs

 

Vaccinations and public health

Conservatives – Will continue to promote vaccine uptake via national vaccination strategy

Labour – Will urgently put vaccination action plan in place to regain our measles-free status in WHO listings. Restore public health grants

Liberal Democrats – Support HCPs to work together across local areas to provide multi-disciplinary health and care services and improve appointments outside of normal working hours, including mobile services. Keep public health within local government, where it is effectively joined-up with preventive community services. Re-instate funding cut from public health budgets by the Conservatives and join up services across public health and the NHS

Green – Build new community health centres to ‘pioneer preventative healthcare’

 

Prescriptions

Conservatives – No specific pledges

Labour – Will abolish prescription charges in England. Will progress ‘clinically appropriate’ prescription of medical cannabis

Liberal Democrats – Make prescriptions for people with chronic mental health conditions available for free on the NHS as part of our commitment to review the entire schedule of exemptions for prescription charges

Green – Make heroin available on prescription after medical assessment by doctor and provide safe facilities for users who inject drugs

 

Medicine prices

Conservatives – The price the NHS pays for drugs ‘will not be on the table’ when negotiating trade deals

Labour – Medicine pricing will be ‘fully excluded and protected’ from any international trade deals. Will establish a generic drug company and if ‘fair prices’ are rejected for patented drugs we will use the Patents Act provisions, compulsory licences and research exemptions to secure access to generic versions

Liberal Democrats – Stop Brexit as it would mean ‘potential delays to medicines’ and increased access by US corporations to services currently provided by the NHS and the UK drugs market ‘if Donald Trump has his way

Green – Make all forms of birth control free of charge


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